The Effects of Physical Activity on Leukemia Symptoms in Children
Cambrian College Site
BSN 4416: Nursing Research
Cancer is a rapid and disorganized disease that is defined by the growth of abnormal cells that is uncontrolled and unregulated (Lewis, Hekemper, Dirksen, O’Brien, & Bucher, 2010). Leukemia is a type of cancer that originates in the blood, specifically in the stem cells located in the bone marrow, most commonly diagnosed in children (Canadian Cancer Society [CCS], 2018). This disease occurs when the body’s stem cells become altered resulting in abnormal functioning of the body’s normal cells as they are overpowered by the leukemia cells (CCS, 2018). Specifically, acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL) are the most common types of leukemia seen in children (CCS, 2018). Between 2009 and 2013 in children from birth to fourteen years of age, a total of 1,445 were diagnosed with leukemia in Canada alone (CCS, 2018). Clarke et al., (2016) describes the main symptoms of childhood leukemia, some of which include: limb pain, fever, frequent infections, fatigue and weakness, bleeding tendencies and hepatosplenomegaly. For the purpose of this research proposal, fatigue and limb pain will be the symptoms of focus.
Physical activity is the movement of the body created by the skeletal muscles that needs the individual’s input of energy (The World Health Organization [WHO], 2018). Exercise is a category that falls under physical activity that can be performed through scheduled, organized, repetitive, and focused activities (WHO, 2018). Huang & Ness (2011), discuss that the physical fitness of children becomes impaired during and post cancer treatment. This impairment of physical fitness can lead to health issues such as: fatigue, reduced muscle strength and cardiopulmonary dysfunction (Huang & Ness, 2011). The exercise that will be focused on in this research proposal is aerobic exercise. Tian, Lu, Lin & Hu (2016) define aerobic exercise as an activity that is constant, rhythmic and tends to occur in long durations with low to modest intensity. Incorporating physical activity into the treatment and care of children with leukemia is important as it can improve their overall health, strength and quality of life (Chamorro, Wurz & Culos-Reed, 2013). Common types of aerobic exercise include: cycling, walking, swimming and jogging (Tian, Lu, Lin & Hu, 2016). For the purpose of this project, walking will be the aerobic exercise implemented as the intervention in the children participating in the study.
Chamorro, Wurz & Culos-Reed (2016) discovered that the studies exploring the effects of physical activity on the symptoms experienced in children with leukemia remain to be in the initial stages, thus clearly evaluating the effects was a challenge identified. Additionally, it was determined that the previous studies have all had small sample sizes which can limit the results found (Chamorro, Wurz & Culos-Reed, 2013). Overall, it was determined that the previous research on this topic shows rising evidence for the benefits of physical activity in this specific population (Huang & Ness, 2011). It was noted that further research is required to find the optimal exercise, duration and intensity for the greatest effects along with utilizing a larger sample size to see if the results remain congruent (Huang & Ness, 2011).
The purpose of this quasi-experimental pilot study is to explore the effects of aerobic exercise on limb pain and fatigue experienced by children with leukemia in Northern Ontario. This topic is relevant to the nursing profession as nurses play a key role in patient care as well as conducting research in the field of oncology (Cummings, Lee & Tate, 2018). Prades, Remue, Van Hoof & Borras (2015), state that multidisciplinary teams ultimately improve the care provided to cancer patients in the healthcare setting. The central hypothesis formed for this study is: Does aerobic exercise have a positive impact on the common symptoms experienced in children with leukemias? The results of this study will help to discover if aerobic exercise has significant effects on the improvement of limb pain and fatigue in this population. This research can possibly determine if aerobic exercise is more effective in reducing these symptoms than the other exercises previously utilized in past studies. Lastly, this study will also explore a larger sample size which has the potential to clarify the impact of the intervention.
Project Plan Overview
Hypothesis – Does aerobic exercise have a positive impact on the common symptoms experienced in children with leukemias?
Methodology – Quantitative, Quasi-Experimental Pilot Study
Population– Children diagnosed with leukemia (Pediatric)
Sample– Will be determined by completing a power analysis
Data Collection Methods– Observation, Pain scales and Fatigue scales
Analysis Strategy– Double difference-in-difference analysis method
This method evaluates the intervention between the focus and comparison group to evaluate the impact of the intervention at baseline and at the end of the study (White & Sabarwal , 2014).
Presentation – Research Proposal Essay
Canadian Cancer Society (2018). What is childhood leukemia? Retrieved November 9, 2018, from http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-childhood/childhood-leukemia/?region=on
Chamorro Viña, C., Wurz, A. J., & Culos-Reed, S. N. (2013). Promoting physical activity in pediatric oncology. Where do we go from here? Frontiers in oncology, 3, 173.
Clarke, R. T., Van den Bruel, A., Bankhead, C., Mitchell, C. D., Phillips, B., & Thompson, M. J. (2016). Clinical presentation of childhood leukemia: a systematic review and meta-analysis. Archives of disease in childhood, 101(10), 894-901.
Cummings, G. G., Lee, S. D., & Tate, K. C. (2018). The evolution of oncology nursing: Leading the path to change. Canadian Oncology Nursing Journal, 28(4).
Huang, T. T., & Ness, K. K. (2011). Exercise interventions in children with cancer: a review. International journal of pediatrics, 2011.
Lewis, S. M., Heitkemper, M. M., & Dirksen, S. R., O’Brien, P. G., Bucher, L. (2010). Medical-surgical nursing in Canada: Assessment and management of clinical problems. Toronto: Elsevier Moseby.
Prades, J., Remue, E., Van Hoof, E., & Borras, J. M. (2015). Is it worth reorganizing cancer services on the basis of multidisciplinary teams (MDTs)? A systematic review of the objectives and organization of MDTs and their impact on patient outcomes. Health Policy, 119(4), 464-474
Tian, L., Lu, H. J., Lin, L., & Hu, Y. (2016). Effects of aerobic exercise on cancer-related fatigue: a meta-analysis of randomized controlled trials. Supportive Care in Cancer, 24(2), 969-983.
White, H., & Sabarwal, S. (2014). Quasi-experimental design and methods. Methodological Briefs: Impact Evaluation, 8, 1-16.
World Health Organization. (2018, February 23). Physical activity. Retrieved from http://www.who.int/news-room/fact-sheets/detail/physical-activity